Patients diagnosed with chronic pain and other debilitating conditions typically reduce, or in some cases, eliminate their use of opioids following their enrollment in state-sanctioned medical cannabis access programs.

Several peer-reviewed studies now document this trend. In contrast to observational, population-based studies — which only seek to identify whether an association exists between the passage of medical cannabis laws and opioid use trends in the general population — these papers explicitly assess individual patients’ relationship with opioids following their registration in state-sponsored access programs.

For example, researchers writing in the May edition of the journal Annals of Pharmacotherapy evaluated the use of opioids in 77 intractable pain patients newly enrolled in the Minnesota Medical Cannabis Program. Researchers reported “a statistically significant decrease in MME (milligram morphine equivalents) from baseline to both three and six months.”

A 2018 study assessing prescription drug use trends among patients enrolled in New York state’s medical cannabis program yielded similar results. On average, subjects’ monthly analgesic prescription costs declined by 32 percent following enrollment, primarily due to a reduction in the use of opioid pills and fentanyl patches. “After three months treatment, medical cannabis improved [subjects’] quality of life, reduced pain and opioid use, and lead to cost savings,” authors concluded.

These conclusions are hardly unique. A study of 244 state-registered chronic pain patients enrolled in Michigan’s medical cannabis program reported: “[M]edical cannabis use was associated with a 64 percent decrease in opioid use, decreased number and side effects of medications, and an improved quality of life. This study suggests that many CP [chronic pain] patients are essentially substituting medical cannabis for opioids and other medications for CP treatment.”

A separate review of over 2,000 chronic pain patients in Minnesota reported that 63 percent of those who used opioids at the time of admission into the program “were able to reduce or eliminate their opioid use after six months.”

Yet another study, this time evaluating the prescription drug use patterns of patients enrolled in Illinois’ medical access program, similarly revealed: “[O]ur results indicate that MC (medical cannabis) may be used intentionally to taper off prescription medications. These findings align with previous research that has reported substitution or alternative use of cannabis for prescription pain medications due to concerns regarding addiction and better side-effect and symptom management, as well as complementary use to help manage side-effects of prescription medication.”

Perhaps most notably, a 2017 study published in the journal PLoS ONE compared prescription drug use patterns among pain patients enrolled in the New Mexico medical access program versus similarly matched control patents who were not. Compared to non-users, over a 21-month period medical cannabis enrollees “were more likely either to reduce daily opioid prescription dosages between the beginning and end of the sample period (83.8 percent versus 44.8 percent) or to cease filling opioid prescriptions altogether (40.5 percent versus 3.4 percent).” Enrollees were also more likely to report an improved quality of life.

Authors concluded, “The clinically and statistically significant evidence of an association between MCP (medical cannabis program) enrollment and opioid prescription cessation and reductions and improved quality of life warrants further investigations on cannabis as a potential alternative to prescription opioids for treating chronic pain.”

Additional information on the relationship between cannabis and opioids is available from the NORML fact-sheet here.